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Urine is normally sterile - this means it's completely free of germs (bacteria) - and only has in it waste chemicals from all of the millions of chemical reactions that go on in your body all of the time.

But in some conditions chemicals that shouldn't normally be there get through the filtering systems in your kidneys and get into your urine. This is where urine dipstick testing comes in.

What is a urine dipstick test?

A urine dipstick test is the quickest way to test urine. It involves dipping a specially treated paper strip into a sample of your urine. This can be done during your appointment with your doctor, midwife or other health professional. The results are usually available within 60-120 seconds. Your sample doesn't need to be sent to a laboratory for a urine dipstick test, although if the test is abnormal you might need to do another sample to be sent for further testing in a laboratory.

What do you need to do for a urine dipstick test?

To have a urine dipstick test done you will need to give your medical professional a sample of your urine. This needs to be in a sterile container. Sterile means it has no living germs (bacteria) in it. Usually if you are asked to provide a sample, you will be given a sterile pot to use. Your urine can still be tested for some things if it isn't in a sterile container but the results might not be as accurate and your urine can't be tested for infection.

To get your sample, you need to pee (urinate) straight into the pot. Ideally you shouldn't pee into something else and then transfer it to the special pot, as then it won't be sterile any more. The best sample is one which is called a midstream specimen of urine (MSU). This means that you start to pee then pass the open pot into the stream of urine and then take it away again when you have caught enough urine. You don't stop peeing while doing this. Tightly put the lid on the pot then wash your hands and the pot.

How is a urine dipstick test done?

Your health professional will use a urine testing strip to test your urine. There are several different kinds of urine testing strips that test for different things in the urine. The strip has squares on it that change colour in the presence of certain substances. The strip will then be compared to a chart on the side of the urine testing strip package. Often the more intense the colour change, the more of the substance there is in the urine.

The first thing that your health professional will do is look at your urine. Normal urine varies in colour from colourless to dark yellow. Various things can affect the way your urine looks, from how much you've been drinking to what you've eaten recently. The smell can also vary widely and is not a good gauge of illness.

What are the results of a urine dipstick test?

A urine dipstick test can look for the following:

Blood

Not normally found in the urine.

May be present if there is an infection.

Can be due to significant underlying disease, such as cancer, in the bladder or kidney (and the prostate gland in men).

In women, it may be contamination if you are on your period at the time of doing the sample.

Will always need to be confirmed by sending the sample for a full laboratory test, as the dipstick test can be positive when there's nothing wrong.

Protein

Protein is normally found in the urine in tiny amounts but these tiny amounts aren't usually picked up on a urine dipstick test.

Protein may be found in larger amounts if there is an infection or if you're pregnant and are developing pre-eclampsia.

Can be the first sign of kidney disease.

Glucose

Ketones

Ketones are chemicals made by the body when it's breaking down fat for energy, which is what we do when we are starving and have used up all, or nearly all, of our stores of sugar (glucose). This is normal.

Ketones are not usually found in the urine.

Ketones may be present if you have diabetes and it's out of control and the levels of sugar in the blood are very high.

Ketones may also be present in women who are pregnant.

Bilirubin and urobilinogen

Bilirubin and urobilinogen are chemicals produced by the liver. They are not normally found in the urine.

If bilirubin is found in the urine it usually means there's a problem with the liver.

Small amounts of urobilinogen may be found in the urine but large amounts suggest a problem with the liver or with red blood cells being destroyed too quickly.

Leukocyte esterase and nitrite

These are both tests for the presence of infection.

Leukocyte esterase test looks for a reaction that only happens if there are lots of white cells in the urine. White cells get into the urine when there is an infection.

Nitrite is not normally found in the urine but will appear there if there are lots of germs (bacteria) in the urine.

Nitrite test can be negative even if there are lots of bacteria in the urine if the urine hasn't been in the bladder for long. For example it will be negative if you do your urine sample soon after having passed urine. Ideally you should wait at least four hours from the last time you had a pee before doing your urine sample.

The urine dipstick test also measures how concentrated the urine is and how acidic it is.

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